Endotracheal (ET) tubes are commonly used to ventilate patients for resuscitation, anesthesia and other critical care procedures. These patients are usually critically ill and unable to breathe on their own. Once inserted, it is desirable to secure the endotracheal tube in a fixed position to prevent movement of the tube or extubation of the tube from the patient's airway.
Traditionally, endotracheal tubes have been secured to the patient by placing adhesive tape on the tube and affixing it to the patient's cheek or face. In some cases twill ties have been used, either alone or in combination with adhesive tape. Commercially available adhesive tape-type products for use with an endotracheal tube holder tend to sag and lift off the patient's face after limited use. Further, because the tape must be removed frequently for suctioning and repositioning, considerable skin irritation and possible infection can occur. Endotracheal tube securing devices which incorporate a biteblock are also available, but have not received widespread acceptance since biteblocks tend to irritate the patient's mouth and tongue after a short period of use.
More importantly, the endotracheal tube is often connected to a heavy, bulky breathing circuit along with a closed tracheal suction catheter, which tends to place a significant load strain and tension, or pulling force, on the endotracheal tube securing device. Also, humidifiers, water condensate traps, and oxygen lines, which may be part of the breathing circuit, add to the weight and tension exerted on the endotracheal tube. In such cases, purely adhesive tape-type products cannot withstand the constant load strain, leading to the tube coming out of position, sagging, or kinking. This misplacement or deformation of the tube can cause the airway to become partially shut off and results in the loss or reduction of administered ventilation to the patient.
Likewise, a rigid bite block-type endotracheal tube securing device suffers from similar problems in that the tube tends to bend or kink at the securement junction where the tube connects to the ventilator circuit and/or catheter. Often, the suction catheter or ventilator circuit will need to be moved or adjusted, causing the kinking of the endotracheal tube due to the weight of the attached equipment and the failure of the securement junction to flex or bend in response to the clinician's manipulation of the equipment.
Accordingly, there is a need for a lightweight, comfortable, easy to use securing device for an endotracheal tube which does not require a bite block, yet will provide maximum tube security and prevents kinking.